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J Am Acad Dermatol. 2014 Oct;71(4):731-7. doi: 10.1016/j.jaad.2014.05.023. Epub 2014 Jun 11.

Self-reported pigmentary phenotypes and race are significant but incomplete predictors of Fitzpatrick skin phototype in an ethnically diverse population.

Author information

  • 1Department of Dermatology, University of California at San Francisco, San Francisco, California.
  • 2Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
  • 3Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California; Department of Medicine, University of California at San Francisco, San Francisco, California.
  • 4Department of Dermatology, University of California at San Francisco, San Francisco, California. Electronic address: ArronS@derm.ucsf.edu.

Abstract

BACKGROUND:

Fitzpatrick skin phototype (FSPT) is the most common method used to assess sunburn risk and is an independent predictor of skin cancer risk. Because of a conventional assumption that FSPT is predictable based on pigmentary phenotypes, physicians frequently estimate FSPT based on patient appearance.

OBJECTIVE:

We sought to determine the degree to which self-reported race and pigmentary phenotypes are predictive of FSPT in a large, ethnically diverse population.

METHODS:

A cross-sectional survey collected responses from 3386 individuals regarding self-reported FSPT, pigmentary phenotypes, race, age, and sex. Univariate and multivariate logistic regression analyses were performed to determine variables that significantly predict FSPT.

RESULTS:

Race, sex, skin color, eye color, and hair color are significant but weak independent predictors of FSPT (P<.0001). A multivariate model constructed using all independent predictors of FSPT only accurately predicted FSPT to within 1 point on the Fitzpatrick scale with 92% accuracy (weighted kappa statistic 0.53).

LIMITATIONS:

Our study enriched for responses from ethnic minorities and does not fully represent the demographics of the US population.

CONCLUSIONS:

Patient self-reported race and pigmentary phenotypes are inaccurate predictors of sun sensitivity as defined by FSPT. There are limitations to using patient-reported race and appearance in predicting individual sunburn risk.

Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

Fitzpatrick skin phototype; Fitzpatrick skin type; eye color; hair color; pigmentary phenotype; predictor; race; skin cancer risk; skin color; sunburn risk; suntan

PMID:
24928709
[PubMed - indexed for MEDLINE]
PMCID:
PMC4165764
Free PMC Article
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